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Syringe
SyringesParts of an Insulin Syringe-Healthwise are commonly used to inject cats and dogs with insulin. The strength of an insulin is measured in International Units (IUs)Making the Unit of Insulin-Standards, Clinical Work & Industry-Bulletin of the History of Medicine-2002. The two common strengths are U40 and U100, meaning 40 units and 100 units per millilitre, respectively. There are syringes designed for use with U100 insulin and syringes designed for use with U40 insulin. You can tell the difference between U100 syringes and U40's at a glance. They are universally color-coded: U100 syringes have orange caps while U40's have red ones. The page link belowChildrenwithdiabetes.com-Syringes--Prescription Needed or Not? lists the locations in which you need or don't need a prescription to buy syringes. Syringe use To inject, pull skin up first, and insert the needle firmly parallel to the body, bevel side up. Insulin syringes are intended for a single use only. Using them twice Vetsulin-Proper Handling of Vetsulin-Reusing Insulin Syringes may contaminate and/or interfere with some insulin's activity, in addition to wearing the protective coating off the needle and causing more pain at injection Petdiabetes.org-Reusing Syringes. Some people use yesterday's syringe or disposable needle as a lancet, though. If you should bend a needle while drawing insulin, discard the syringe and start again; don't try to straighten it outInjecting Insulin-Transcript of American Diabetes Association Videotape. Inserting the needle all the way into the vial makes it less easy to bendWashington State University-Diabetes Mellitus. General Tips *If drawing insulin from a vial, set the syringe plunger to the dosage you want to draw, put the needle into the top of the vial while the vial is still upright, and push all the air out of the syringe. This will maintain air pressure equilibrium in the vial once you draw the dose and, because the vial is upright, will not cause air bubbles to mix with the solution. Turn the vial upside down and draw the insulin. If you do get air bubbles into the syringe, it's ok with most insulins to re-inject the insulin into the vial and draw again until the air is gone. Check that this is ok with your insulin. See also injecting insulin. Another way to get rid of syringe air bubbles is to hold the syringe upright and give it a tap or two with your finger. The problem with having air bubbles in the injection is that you will not be getting the full dose of insulin; the bubbles take the place of it American Diabetes Association 2002 Position Statement-Insulin Administration. *Do NOT wipe the needle with alcohol as it removes the protective coating which makes injection easier and less painfulPetDiabetes.org-Tips for Comfortable Injections. * Some caregivers find that certain syringe brands are less susceptible to air bubbles than others because they have a smoother push and pull motion. If you consistently have problems with air bubbles, consider trying other syringe brands. *For very fine doses (less than half a unit increments), some people have tried: **Using a magnifier. **Diluting the insulin (this must be done with the correct diluent and usually is done by a pharmacist.) **Using a U100 syringe with U40 insulin and converting (see Conversion below). **Experimenting with the size of droplets they can coax from a syringe, learning those sizes, and measuring them against fractional unit sizes. **Learning to eyeball fine doses down to 0.1 unitsSyringe Fine Gradations. **Plungers may be pushed or pulled with a "screwing" motion for finer control of partial units. Prefilling tips There are times when you may want to prefill a syringe with a known dose and leave it for yourself or someone else to use later. If doing so, keep in mind: *Recap the needle with great care -- needles can easily go through the side of the cap into your fingers. *Store the recapped needle point-up to avoid clogging the needle. *If the insulin needs refrigeration normally, so do the prefilled syringes. * The "cloudy" insulins (NPH, Lente/Ultralente, PZI, Mixes) need to be re-suspended before use. Gently roll the syringe back and forth in your hands as with the vial. Improperly suspended insulin may lose some or all of its effectiveness. *Some insulins, including Lantus and Vetsulin, will react with the syringe's inner coating over time and lose effectiveness, or even lose their time-delay action. Check with your insulin manufacturer if prefilling syringes is permitted. *According to Novo NordiskBddiabetes.com-Prefilled Syringes, prefilled syringes containing any of their Novolin, Actrapid, Insulatard, Actraphane, and Mixtard insulins can be kept refrigerated for 30 days. Eli Lilly says any of their Humulin insulins in prefilled syringes are good for 21 days when refrigerated. U100 Syringes Because U100 insulin syringes are designed for human use, they are available from brick-and-mortar or Internet pharmacies that sell diabetic supplies. You also can order from an Internet pet pharmacy such as Drs. Foster & Smith Drs. Foster & Smith Website. All U100 insulin syringes, no matter what brand or what country they are purchased in, have color-coded orange caps. All U40 insulin syringes have red ones. In the US, you can expect to pay $15 to $25 for a box of 100 U100 syringes depending on the retailer and the features of the syringe. Barrel. U100 syringes are available in 3 barrel sizes: 1cc, 1/2cc, and 3/10cc. The size refers to the maximum volume of insulin the syringe will hold. * The 1cc syringe holds a maximum of 100 units of U100 insulinClose-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2". They are numbered in 10 unit increments. The smallest lines on 1cc (100 unit capacity) syringes measures 2 unitsDiabetes Mellitus-Washington State University. * The 1/2cc syringe holds a maximum of 50 units of U100 insulinClose-up of BD 1/2 cc Syringes--UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2". They are numbered in 10 unit increments. The smallest lines on 1/2 cc (50 unit capacity) syringes measures 2 unitsChildrenWithDiabetes.com-Photo of BR 1/2 cc Syringes. * The 3/10cc syringe holds a maximum of 30 units of U100 insulinClose-up of BF 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2". They are numbered in 5 unit increments. The smallest lines on 3/10 cc (30 unit capacity) syringes measures 1 unitDiabetes Mellitus-Washington State University. Specially marked Half-Unit Scale 3/10 cc syringes are numbered in 5 unit increments. The smallest lines on Half-Scale 3/10cc (30 unit capacity) syringes measures 1/2 unitChildrenWithDiabetes.com-Photo of 3/10cc syringes--Half-Unit Markings. If for any reason you need to change the size of the syringe you normally use, extra care at drawing insulin will be needed. Those normally using 3/10 cc syringes, with single or half unit markings, could risk giving too much insulin by following the mark on 1/2cc and 1cc syringes; their smallest non-numbered marks indicate 2 units. Because of the small number of insulin units given to cats, most caregivers use the 3/10cc syringe when it is available. The 3/10cc syringe has 1 unit marks. Some manufacturers also have 3/10cc syringes with 1/2 unit marks.Diabetic Promotions Diabetic Promotions link to 1/2-unit marked syringes by mail Needle. U100 syringes come with a long (12.7mm or 1/2”) or short (8mm or 5/16”) needle. Most syringes with 1/2 unit markings come in the short length, although some manufacturers do put long needles on barrels with 1/2 unit markings. Some caregivers with long-haired cats prefer the long needle so that they make sure they make it through the fur to the skin. Some feline caregivers prefer the short needle because it minimizes the chance that they will “shoot through” the tent and spill the insulin onto the cat’s fur on the other side. However, some caregivers report difference in insulin absorption with different length needles. BD DiabetesBDdiabetes.com-Using Short Needles explains that you should consult with your health care professional before using a short needle, and carefully monitor blood glucose when changing to a shorter needle. Some people have found their blood glucose not well-controlled when switching to the shorter needles; this also has been the case with some dogs. Switching back to a longer needle solved the problem. You should consider experimenting with the different length needles. Gauge. U100 syringes come in different thicknesses of needle: the gauge. The higher the gauge, the thinner the needle. Common gauges range from 28 to 31. Caregivers report that thinner needles make the shot more comfortable for the cat. The 31 gauge syringes are available only with short needles. A 2000 study of children with diabetes ranging in age from 8-21 years compared bleeding, pain/discomfort and insulin leakage using 27-30 gauge needles. Overall, the doctors found no significant differences between any of the needle gauges usedPediatric Diabetes 2000-Thinner Needles Do Not Influence Injection Pain, Insulin Leakage or Bleeding in Children & Adolescents With Type 1 Diabetes. Syringe brands. Common brands of U100 syringes are BD Hocks.com-BD U100 Insulin Syringes and MonojectHocks.com-Monoject U100 Insulin Syringes. The Children With Diabetes page link belowChildrenwithdiabetes.com-Insulin Syringe Comparisons has links to syringe brand comparisons. The page linked belowChildrenwithdiabetes.com--Overview of all U100 BD Syringe Typesgives an overview of all BD syringe types with clickable photos that enlarge. Wal-MartWal-Mart-ReliOn Insulin Delivery Devices has a house brand of syringes, ReliOn, that compare to BD syringes in everything except price ReliOn-FAQs-Insulin Delivery Devices. The page belowChildrenwithdiabetes.com-Comparison of ReliOn & BD Syringes has a clickable photo that enlarges for better comparison of the BD syringe and the ReliOnClose-up Comparison-ReliOn 3/10 Short With Half-Unit Markings (Top) & BD UltraFine II Short (bottom). Wal-Mart also has ReliOn/Novolin branded insulins, which are made for them by Novo Nordisk. The only difference here also is in the price. Precision Sure-Dose syringes are marketed by Abbott. They compare favorably to BD, but cost quite a bit less. The link belowChildrenwithdiabetes.com-Abbott Precision U100 Sure-Dose Syringe Comparison describes all available models and has a clickable photo that enlarges for a better lookClose-up of a Precision Sure-Dose Syringe. CVS pharmacies in the US stock and offer Precision syringes. Ulti-CareUltiCare-Consumer Ordering Information-Ulti-Care U100 Syringes offers U100 syringes with barrel sizes 3/10 cc (no 1/2 unit markings), 1/2 cc, and 1 cc with a variety of needle gauges from 28-31. Its 28 and 29 gauge syringes have a 1/2" needle while its 30 and 31 gauge syringes have a 5/16" needle. Factoring in shipping, the prices are about equal to buying syringes offline. No prescription is needed to purchase syringes from UltiCare; it is located in Minnesota where no state law requires it. Shipping within the US only. Hocks.comHocks.com-U100 Insulin Syringes offers a broad range of U100 syringes at reasonable prices. Shipping within the US only. Diabetic PromotionsDiabetic Promotions Online Shopping offers another large selection of syringes and supplies, and will ship to Canada. Comparison chart showing all types of U100 insulin syringes sold in the USComparison Chart Showing All Types of U100 Syringes Sold in the USfrom Diabetes Health Magazine. Injection Helpers If you feel all thumbs when giving shots or think you need more than two hands when giving them, BD's Inject-Ease may be just what you need. The device holds a filled BD insulin syringe (Micro-Fine or Ultra-Fine BD brands). Inject-Ease inserts the needle into the skin and delivers the injection at the touch of a button. You may need to have your pharmacy orderBD Diabetes-BD Inject-Ease this for you. It's a big help with both small children and pets needing insulin shots. It has been used with success for some CDMB dogs who were difficult at injection time. Finer Doses Some people find that dose differences as small as 0.1 units make a difference. Since a cat or small dog weighs 1/10 what a human does, it may easily be the case. If 0.2 units and 0.3 units actually seem to give a different result in your cat or small dog, you may find it useful to try half-unit marked syringes. This guide shows how to read fine doses of 0.1 through 0.5 units.Syringe Fine Gradations U40 Syringes Many caregivers use the insulins Caninsulin/Vetsulin, PZI, and other U40 strength insulin with U40 syringes. Comparing two 1/2cc syringes side by side, you will see that the units on the U40 syringe appear larger than that of the U100 syringe. If you were to take the two syringes and fill them with insulin, water, or any other fluid, both the U100 and the U40 syringe would each hold 1/2cc of it. All U40 syringes, regardless of brand or country they are purchased in, have color-coded red caps--all U100 syringes have orange ones. This article has a photo of a Caninsulin syringe shown above. Vetsulin syringes would be identical to these, as Vetsulin is the US brand name for the Intervet insulin. The manufacturers of Caninsulin make special syringes with magnifying glassesCaninsulin-Caninsulin Syringe With Magnifying Glass to help to ensure that the correct dose of insulin is drawn up. Ulti-CareUltiCare-Consumer-Ulti-Care U40 Insulin Syringes offers U40 insulin syringes in both 1/2cc and 1cc barrel sizes. All of its U40 syringes have 29 gauge, 1/2" needles. The 1/2cc syringes are offered with and without the UltiGuard disposal system; if you want to buy 1cc syringes from this company, they are only offered with the UltiGuard disposal system. These are comparable to BD syringes, and it appears that the 1/2cc syringes minus the UltiGuard disposer are cheaper than the Caninsulin/Vetsulin syringes. Shipping within the US only and no prescription needed to buy from UltiCare. Drs. Foster & SmithDrs. Foster & Smith Website also has U40 syringes. Conversion Though it's not recommended by veterinarians, some caregivers use a U100 syringe with a U40 insulin. That requires “converting” the U40 concentration to a U100 strength. See the conversion table at the link belowFelinediabetes.com-Using U100 Syringes For U40 Insulins-Conversion Table. If you choose to use the U100 syringes for U40 insulin, a fast way to calculate the right amount of units is to multiply the number of U40 units given by 2.5. The advantage of doing this conversion is the possibility of greater precision for low-dose animals -- precise dose increments of 0.2 units are possible with half-unit marked U100 syringes. On the other hand, if you find the conversion confusing, it's best not to try -- it can be extremely dangerous to get this math wrong. Syringe disposal You should dispose of syringes and other "sharps," like lancets, in accordance with your local, state or provincial, or national laws. Consult your trash company, your local or state/provincial health department, or your vet or pharmacist for that information. In some places, sharps have to be disposed of as "medical waste." Some people take them to the vet or pharmacy for such disposal--whether required to by law or not--although that may involve a fee. In other places, there are no specific requirements. You can seal them in a plastic container (such an empty laundry detergent or soda bottle), mark them as sharps, and put them in the regular trash. Some pharmacies also carry sharps containers for about $3-$5 in the US. This page link belowChildrenwithdiabetes.com-Needle Disposal has links to additional information under the heading "Needle Disposal." It may also be possible to fire them into spaceInsulin Needle Rocket, though this is not recommended :). Further Reading *Washington State University-Diabetes Mellitus Good general information--photos and tips about how to draw insulin. 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